Individual
DR. BROCK JESSE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
631 JASON ST NE STE 150, SALEM, OR 97301-2750
(503) 854-0153
Mailing address
631 JASON ST NE STE 150, SALEM, OR 97301-2750
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11037
OR
Other
Enumeration date
05/29/2019
Last updated
05/29/2019
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